27 Systemic Mycoses 1 Flashcards

1
Q

Endemic mycoses share some features. These are? (6, review more than memorize)

A

-In nature-In a geographic region-Inhale->lungs->dissemination-human-human transmission almost never occurs-often asymptomatic-healthy CAN be infected

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2
Q

A bronchoscopic biopsy grows mold 5 days after visiting California central valley. I’ve got fever, chest pain, cough, night sweats. What do I have?

A

Coccidioidomycosis

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3
Q

Doc, what will happen to me now that I’ve got coccidioidomycosis? (3)

A

-asymptomatic (60%)-valley fever that goes away on its own (30%)-progressive lung nodules or dissemination

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4
Q

How is coccidioidomycosis diagnosed? (4)

A

-spherules on wet prep-BIOHAZARD for lab (like all dimorphics)-IgM or IgG in serum are useful for those NOT in endemic areas-hyphae w/ alternating barrel-shaped arthroconidia

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5
Q

coccidioidomycosis treatment?

A

usually not needed

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6
Q

A chimney sweep or a bat cave explorer comes to you w/ pneumonia symptoms. What is it?

A

histoplasmosis

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7
Q

Histoplasmosis pathogenesis?

A

inhale microconidia/spores ->budding yeasts in body -> get yeasts in macrophages (or disseminates by bloodstream)

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8
Q

Histoplasmosis symptoms?

A

-95% asymptomatic-Lung: either self-limited, or chronic cavitary fibrosing mediastinitis-Systemic: sepsis in immunocompromised

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9
Q

Histoplasmosis diagnosis?

A

-BIOHAZARD dimorphic: Giemsa stain & see yeast both extracellular and inside macrophages. (look like acorns)-Urine antigen test BEST

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10
Q

African histoplasmosis is caused by what organism?

A

histoplasma capsulatum var. duboisii

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11
Q

How is African histoplasmosis different than normal histoplasmosis?

A

-Larger, thick-walled yeast-Get giant cells-Less pulmonary involvement, but more bone/skin problems.

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12
Q

Histoplasmosis treatment?

A

Usually none. For severe: amphotericin B

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13
Q

Wisconsin! (or EAST U.S.) Lung, skin, & bone lesions, what fungus?

A

Blastomycosis[broad based budding!]

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14
Q

Blastomycosis is asymptomatic in what %?

A

1/2 (so high virulence for a fungus) (it can turn chronic in some!)

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15
Q

Blastomycosis diagnosis involves what?

A

-BIOHAZARD dimorphic. Wet prep, culture (which takes 4 wks!), or ELISA for exoantigen A.-Broad-Based Budding & lollipops coming off the hyphae!

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16
Q

Blastomycosis treatment?

A

-Amphotericin B (or others, the point is you actually DO treat this fungus)

17
Q

I’ve got fever, cough, nodular lung lesions, painful ulcerated oro-labial lesion. Rarely my disease disseminates. I just came from Guatemala. What do I have?

A

Paracoccidioidomycosis “South American Blasto”

18
Q

I look like a pilot’s wheel on wet prep. What am I? Should I be treated?

A

-paracoccidioidomycosis.-Yes

19
Q

I’ve got a rash on face, lymphadenopathy, palpable spleen tip, bilateral chest x-ray infiltrate. HIV positive, and I came from Vietnam. What do I have?

A

Penicillium marneffei [think HIV in SouthEast Asia! Soil and bamboo rats.]

20
Q

What does Penicillium marneffei look like on stain?

A

elliptical yeast form w/ fission septae. red. (dimorphic beware!!)

21
Q

Penicillium marneffei treatment?

A

amphotericin B

22
Q

I rolled in pigeon poo. I’ve got pulmonary problems, MENINGITIS, fatigue, somnolence, HIV, mental status changes, and you see encapsulated yeast on india ink prep as well as a positive polysaccharide antigen test in CSF (BEST test) as well as mucoid yeast colonies that grew on GMS stain. What do I have?

A

Cryptococcus neoformans (C. gatii if the pigeon lived in a eucalyptus tree)[think meningitis in HIV patient! It it’s NOT an HIV patient, it’s C. gatii)

23
Q

What antibiotic is used for life for prophylaxis of some fungi for immunocompromised?

A

fluconazole

24
Q

What antibiotic is used for really bad fungal infections?

A

amphotericin B